Olfactory Reference Syndrome

Olfactory Reference Syndrome

What is Olfactory Reference Syndrome?

Olfactory Reference Syndrome is characterized by an excessive, obsessive thoughts, and irrational fear that one is emitting a foul or unpleasant odor. This obsession may involve an exaggerated concern with one’s natural body smell or may concern a non-existent odor that is entirely imagined by the individual experiencing it. Those experiencing Olfactory Reference Syndrome are significantly impaired by their experience as they are deeply concerned about their odor and may change jobs repeatedly, avoid engaging in relationships, or become housebound as a result of the embarrassment they feel or as a result of concern that others are talking about their odor.

What are the symptoms?

The common symptoms associated with Olfactory Reference Syndrome are as follows:


  • Exaggerated fear of having extremely bad breath.
  • Fear of having a foul odor emitting from a specific body part or having overall body odor that is unnatural, non-human or chemical in nature.
  • Belief that the behaviours of others are a response to their experience of the imagined bad odor or that they are making comments about the bad odor.


  • Repetitive showering and grooming behaviours including excessive use of mouth wash, deodorant and perfume.
  • Repetitive checking of oneself for the source of the imagined odor.
  • Seeking reassurance from others that there is not odor or repetitive visits to the doctor to investigate the odor.
  • Avoidance of social situations out of shame, embarrassment and fear that others will notice the smell.

Why does it occur?

While it is difficult to pinpoint the exact cause of Olfactory Reference Syndrome, it has been suggested that it may be triggered by significant negative experiences. There are two types of negative experiences that may contribute to the development of Olfactory Reference Syndrome. Firstly, a traumatic incident that was related to smell, and secondly, significant life stressors unrelated to smell but present when the condition developed.

What treatments are available?

As Olfactory Reference Syndrome shares the same cycle of obsessive and compulsive behaviours that is seen in Obsessive Compulsive Disorder, the treatment for Olfactory Reference Syndrome are similar to that for OCD. The primary treatment for both Olfactory Reference Syndrome and OCD is a facet of Cognitive Behavioural Therapy (CBT) called Exposure and Response Prevention (ERP) which involves confronting obsessive beliefs and accepting them without engaging in compulsive behaviours. Clients also engage in a technique called Cognitive Restructuring, which aims to challenge the validity of client’s beliefs regarding their odor. Furthermore, Mindfulness-Based CBT has been found to be highly effective in the treatment of Olfactory Reference Syndrome as it teaches clients to accept uncomfortable thoughts without needing to control or eliminate discomfort.